'Parent Training' May Help Kids With Autism Behave Better

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THURSDAY,
March 1, 2012 (HealthDay News) — Children with autism often display challenging
behaviors, but new research suggests that parents can learn to better handle
tantrums and aggression, which may improve their child's overall functioning.

"Parent training is
one of the best, evidence-supported treatment interventions in child psychiatry
for other conditions, such as for children with ADHD or children with
oppositional defiant disorder," said senior study author Lawrence Scahill,
a professor at Yale University School of Nursing and Child Study Center in New
Haven, Conn. "But strangely enough, it had never really been tried with
children with autism or with developmental disabilities, so we had to make our
own manual."

The study involved 124
children aged 4 to 13 with an autism spectrum disorder and serious behavioral
issues, including daily, prolonged tantrums, aggression or self-injurious
behavior. The children were prescribed risperidone (Risperdal), an
antipsychotic drug approved by the U.S. Food and Drug Administration for
treating severe behavioral problems in children with autism.

Half the children and their
parents were also assigned to a six-month, structured "parent
training" program. Parents were asked to identify the most difficult,
disruptive behaviors and to think about what preceded the incidents and why the
child might do it. They then worked with counselors to devise strategies to
avoid the triggers and help the child respond better to the everyday stressors.

Parents who underwent
training reported a greater decrease in problem behaviors than the parents of
children on medication alone, researchers found. By the end of the study, the
average dose of risperidone was
lower for kids in the parent-training group.

"On the tantrums, the
aggression and the self-injury, the combination of medications and parent
training was better," said Scahill. "How much better? Not a huge
amount, but it was an incremental improvement over an already effective
improvement."

Parents who received
training also reported improvements on a test known as the Vineland Adaptive
Behavior Scale, which measures how well a child does everyday activities, such
as communicating, socializing, dressing, eating at the table and going to
school.

By diminishing serious
problem behaviors, such as tantrums
and aggression, children's skills in other areas improved, but the difference
was not statistically significant.

The study is published in
the February issue of the Journal of the American Academy of Child
& Adolescent Psychiatry.

Researchers plan to share
the manual with the public. The training involves in-person sessions with a
parent-training therapist, phone sessions and home visits that take place over
several months.

Dr. Joseph Horrigan,
assistant vice president and head of medical research for Autism Speaks, said
studies like this provide more evidence that parent training can help kids and
their families cope with autism-related behavioral problems.

The approach is
"pragmatic and practical," he added. "We're all doing our best
as parents, but we can all use a second set of eyes and an expert opinion to
better our game, and this is shedding that light on the technique."

It also makes the point
that medication isn't the
only way to help kids with autism, he added.

In any case, not all
children with autism should or would be prescribed risperidone, experts said.
The drug, also used to treat schizophrenia and bipolar disorder, is for
children with very serious behavioral issues that affect their ability to
function in daily life in an extreme way, Scahill said.

Parents shouldn't take the
term "parent training" to mean they are doing something wrong,
Scahill said. Rather, with an expert's help they may learn tricks that make
their life — and their child's life — a little easier.

"One of the first
things I tell parents, we are not blaming the parents," he said.
"Children with an autism spectrum disorder present unique challenges to
parents. Children with autism spectrum disorder who also have disruptive
behaviors present even more challenges."

"If a parent had a
child with a serious medical condition like diabetes or asthma, there are all
kinds of things that parent would have to learn that average parents don't, and
so it is with children with autism spectrum disorder," he added.
"There is no reason to think a parent would automatically know how to
manage these problems."

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